Posterior Fossa Dermoid Cyst Research Articles

Posterior Fossa Intradural Dermoid Cyst with a Dermal Sinus Complicating with Cerebellar Abscess and Acute Obstructive Hydrocephalus in a Child: Case Report

Posterior Fossa Dermoid Cysts (PFDCs), associated with a Dermal Sinus (DS), are rare congenital brain tumors. More rarely, PFDCs may complicate with cerebellar abscess or hydrocephalus. These complications are represented in only a few case reports as a separate entity.

Atypical posterior fossa dermoid cysts: unusual but predictable imaging features.

Atypical posterior fossa dermoid cysts: unusual but predictable imaging features.

Pediatric posterior fossa dermoid cyst: Diagnostic dilemma

Abstract Dermoid cysts are rare congenital lesions of the brain. They are commonly located in the supratentorial region. Infratentorial dermoid cysts are uncommon. They can occupy cerebellopontine angle, midline posterior fossa, or brain stem. Midline post fossa dermoid cysts can be confused with another common lesion in this location. We describe a case of midline posterior fossa dermoid cyst in a 6-year-female child who presented with signs and symptoms of raised intracranial pressure. Magnetic resonance imaging showed posterior fossa lesion which was hypointense on T1-weighted images, hyperintense on T2-weighted images, and not enhancing on intravenous contrast administration. The lesion showed restricted diffusion on diffusion-weighted images. Radiological diagnosis was an epidermoid cyst. However, during surgery, we found hair follicles. Histopathological examination revealed dermoid cyst. The child recovered completely following cyst excision. We present a case of a posterior fossa dermoid cyst mimicking epidermoid cyst.

Infected Dermoid Cyst of the Posterior Fossa: Case Report

Intracranial dermoid cysts are a rare congenital benign neoplasms, they account for only 0.1%-0.7% of all intracranial tumors [1]. They arise from inclusion of ectodermal elements within the neural tube during its closing between the third and fifth week of embryonic development [2]. Patients with a posterior fossa dermoid cyst and an associated dermal sinus may develop bacterial meningitis or abscess formation of the dermoid itself [3]. Here in, we present a case of dermoid cyst with occipital dermal sinus, complicated by abcess.

Recurrent cerebellar abscess secondary to cranial dermal sinus associated with dermoid cyst in children

Background: Posterior fossa dermoid cysts are rare, benign lesions whose diagnosis can be quite challenging because of their slow growth and subsequent paucity of symptoms. We present herein an unusual case of recurrent cerebellar abscesses induced by an adjacent extradural dermoid cyst with a complete occipital dermal sinus. Methods: The authors report the case of a 20-month-old girl who presented with signs of acutely raised intracranial pressure and whose head scans showed a left cerebellar hemisphere abscess associated with obstructive hydrocephalus. The patient was treated initially with an external ventricular drain, followed by burr-hole aspiration of the abscess and long-term antibiotics. Since the cerebellar abscess recurred, a posterior fossa craniotomy was performed and gross total resection of the lesion along with the dermal sinus tract and abscess contents was achieved. Histopathological analysis confirmed a dermoid tumor. Conclusions: The occurrence of recurrent cerebellar abscesses must always rise up the suspicion of an associated dermoid cyst. Neuroradiological scans should be carefully evaluated in search for this lesion. Once the diagnosis is established, radical resection of the cyst, sinus tract and infectious components is the treatment of choice.

Microsurgical Resection of Craniocervical Dermoid Cyst by Far Lateral Approach: Case Report and Literature Review

Introduction Intracranial dermoid tumors represent a rare clinical entity that accounts for 0.04 to 0.6% of all intracranial tumors. Their location in the posterior fossa is uncommon. Objectives To report the case of a young woman with a posterior fossa dermoid cyst treated by right far lateral approach. Case Report A 17-year-old woman presenting with swallowing difficulties for 6 weeks was referred for a neurological investigation. A magnetic resonance imaging (MRI) scan showed a hyperintense T1-weighted large expansive lesion occupying the posterior fossa and compressing the anterior face of the brain stem and cerebellum. The patient underwent surgical treatment by right far lateral approach with decompression of vascular and neural structures. The patient presented an uneventful recovery, and was discharged home on the fourth postoperative day without any additional neurological deficits. The anatomopathological analysis confirmed the diagnosis of dermoid cyst. Conclusion The far lateral approach is a safe and feasible route to appropriately treat large posterior fossa dermoid cysts. Decompression of vascular and neural structures is essential to achieve good symptom control.

Kystes dermoïdes de la fosse cérébrale postérieure chez l’enfant révélés par des méningites aseptiques récidivantes : à propos de deux cas et revue de la littérature

IntroductionDermoid cysts of central nervous system are very rare. The usual clinical presentation is dominated by intracranial hypertension, epilepsy and cranial palsy. The revelation mode could be recurrent aseptic meningitis. AimThe aim of this case report is to consider the dermoid cyst as regards the differential diagnosis in children treated for recurrent aseptic meningitis to avoid misdiagnosis and ice qui a orienté le diagnostic à une méningitnadequate treatment. MethodsTwo children were admitted in the pediatric department for recurrent aseptic meningitis. The MRI confirmed the presence of a posterior fossa dermoid cyst. ResultsLoss of meningitis after microsurgical resection. ConclusionThe diagnosis of dermoid cyst is performed and reconsidered at an early stage in aseptic meningitis in order to establish an adequate therapy, which is surgery.

Atypical imaging features of posterior fossa's dermoid cyst: Case report and review of literature

Background:Intracranial dermoid cysts are uncommon lesions with characteristic imaging appearances. Symptomatic clinical presentation usually occurs in one of two ways: mass effect or rupture. Radiologically, dermoid cysts typically present as low density masses on computed tomography (CT) scan and are generally hyperintense on T1-weighted magnetic resonance imaging (MRI) sequences with variable signal on T2-weighted sequences.Case Description:We present the case of a 35-year-old female presented with symptoms of increased intracranial pressure. Radiological investigations showed a cystic posterior fossa tumor that was not only hyperdense on CT scans but also hypointense on MRI T1-weighted images. The patient underwent a total-gross resection of an extra-parenchymal posterior fossa tumor. Pathologic examination of the specimen concluded to dermoid cyst.Conclusion:Dermoid cyst of the posterior fossa is a benign lesion surgically treatable. Only an appropriate radiological diagnosis of this lesion would permit a well-targeted therapeutic approach.

Occipital dermoid cyst associated with dermal sinus complicated with meningitis: A case report

Occipital dermal sinus, usually associated with dermoid cyst, is a rare entity; it results from the persistence of an abnormal embryonal communication between the skin and the intradural space. Its main complication is intracranial infection. This 2-year-old girl was hospitalized for meningitis. Neuroradiological studies revealed a cystic mass of the posterior fossa communicating with the skin and hydrocephalus. The diagnosis of dermoid cyst associated with dermal sinus was established at surgery. The patient was treated with radical excision of both the occipital cyst and the dermal sinus associated with systemic antibiotic therapy. She had a good outcome. Posterior fossa dermoid cyst should be considered in all children with chronic occipital skin lesion, especially a dermal sinus. We emphasize the importance of early neurosurgical treatment of dermoid cysts to prevent the development of severe complications.

Cerebellar dermoid cysts with hydrocephalus

Intracranial dermoid cyst is a rare entity, accounting less than 1% of all intracranial tumors. The most common localization is midline at the posterior fossa. They usually cause symptoms related to compression, infection, hydrocephalus, or a combination of all. The controversy arises about the preoperative treatment planning. Since infection is a major risk in those patients, inserting a shunt at the same session of tumor removal may not be achieved. Total resection of tumor is a must. We present two cases of posterior fossa dermoid cysts with hydrocephalus as a complication. First case presented with the symptoms of meningitis. She had no hydrocephalus at the time of surgery. The second case had hydrocephalus but no sign of infection. Both cases needed ventriculo-peritoneal shunt insertion. Hydrocephalus may occur at any time during the course of the disease. But appropriate time of handling is important to avoid increased morbidity and mortality related to the shunt infection failure. (J Pediatr Neurol 2004; 2(3): 163–166).

Rupture of a Posterior Fossa Dermoid Cyst Overlying the Torcular with Extracranial Extension: Technical Note

Intracranial dermoid cysts are congenital benign neoplasms mostly diagnosed in the pediatric hood and usually involve the midline structures. They count approximately less than 1% of all intracranial neoplasms and are believed to arise from ectopic cell rests incorporated in the closing neural tube. These dermoid cysts, especially those involving the posterior fossa and overlying the torcular, are uncommon. We report perhaps the first case of this entity in a third-year-old boy and discuss the physiopathogenesis, the imaging features and the best technical note to manage this cyst in this location.

Dermoid cysts of the posterior fossa – morbid associations of a benign lesion

Dermoid cysts of posterior fossa are uncommon benign lesions. They differ from other lesions found in the infra tentorial compartment by virtue of their associated conditions. Due to their association with dermal sinus tracts, intracranial infection is a potential threat following infection of the cyst. Due to their embryologic origin, these cysts may also be associated with other congenital anomalies. In this article we detail our eleven-year-experience with posterior fossa dermoid cysts in fifteen patients. Despite the morbid presentation with severe life-threatening complications, the overall outcome was excellent. Implications of the various associations are discussed.

Klippel-Feil syndrome associated with a craniocervico-thoracic dermoid cyst

Background:Uncommonly, Klippel–Feil syndrome (KFS) has been associated with intracranial or spinal tumors, most frequently dermoid or epidermoid cysts. Although the associated dermoid cyst (DC) is usually located in the posterior fossa, isolated upper cervical DC has been reported. Extension from the posterior fossa to the upper cervical spine (C2) has been reported once. We report a rare case of KFS in association with a posterior fossa DC that extended down to the upper thoracic spine and review the current literature.Case Description:A 47-year-old female with presented cervical myelopathy related to a cranio-cervico-thoracic DC in association with KPS-related cervicothoracic fusion (C2-T6) and thoracic kyphosis. The patient underwent complete tumor resection following sub-occipital craniectomy and C1-C4 cervical laminectomy. The patient exhibited complete resolution of symptoms with no tumor recurrence and no deformity at 6-year follow-up.Conclusion:DC should be added to the list of congenital central nervous system abnormalities, which should be sought in patients with KFS. Therefore, the presence of a cystic lesion in the posterior fossa, the craniocervical junction or the anterior cervical spine should suggest the possibility of a DC in patients with KFS. In cases of cranio-cervical DC, the tumor may extend quite far down the spinal column (reaching the thoracic spine), as demonstrated in the present case.

Primary amenorrhea due to empty sella: an underestimated entity

We report a 16-year-old girl who had stunted growth and primary amenorrhea presenting with headache and vomiting. MRI of brain showed posterior fossa dermoid cyst with hydrocephalus and empty sella. Growth hormone (GH), Leutinizing hormone (LH) and Follicular stimulating hormone (FSH) were grossly reduced on endocrinological work-up. She underwent suboccipital midline craniectomy and complete excision of dermoid cyst .She had no additional deficit after the surgery. She had menarche six months after the surgery and developed adequate secondary sexual characters, however her height remains subnormal at follow-up after 2 years as compared to age matched controls. We briefly review the radiological features, pathogenesis and outcome of this underestimated entity.

Posterior Fossa Dermoid Cyst With Sinus Tract and Meningitis in a Toddler

Intracranial dermoid cysts are rare, but can cause recurrent bacterial or aseptic meningitis, abscesses or mass effect. We describe a toddler who manifested an occipital "lump" for 6 months without further evaluation. He presented with lethargy and meningitis. A posterior fossa dermoid cyst with a sinus tract was detected by imaging studies. He underwent prompt surgical excision of the cyst and the sinus, and received a prolonged course of antibiotics, because anaerobes were isolated from the contents of the cyst and blood. His postoperative course was complicated, and required the placement of a lumboperitoneal shunt. A high index of suspicion for the detection of dermoid cysts is required when a congenital midline skin lesion such as a dimple or a scalp swelling is reported. Prophylactic excision is indicated to prevent serious sequelae.

Dermoid cyst of the posterior fossa associated with congenital dermal sinus in a child

Intracranial dermoid cysts are congenital benign neoplasms. Hydrocephalus and abscess as the principal manifestations of the posterior fossa dermoid cyst are rare. We present a case of obstructive hydrocephalus and abscess induced by an adjacent dermoid cyst with occipital dermal sinus. A 2-year-old girl presented with headache and vomiting. Physical examination showed nothing abnormal except for a small subcutaneous nodule above the occipital protuberance with a small skin opening. She had no neurological deficits. Neuroradiological studies including CT and MRI showed a cyst located in the posterior fossa. The cyst in the posterior fossa with occipital dermal sinus was diagnosed. She was treated by radical excision of the occipital cyst through a suboccipital approach, and was followed up. Histopathologic examination suggested a dermoid cyst with an abscess. Bacterial investigation revealed Staphylococcus epidermidis, and appropriate systemic antibiotic therapy was given. The child recovered and a 2-year follow-up was uneventful. Posterior fossa dermoid cyst should be considered in all children with occipital skin lesions, especially dermal sinus. CT and MRI scan are helpful in the diagnosis of the lesion. Neurosurgical treatment of the lesion should be planned early to prevent infections such as abscess and meningitis.

Posterior Fossa Abscesses Secondary to Dermal Sinus Associated with Dermoid Cyst in Children

We report on the rare disease of posterior fossa abscesses secondary to dermal sinus associated with dermoid cyst in 4 pediatric cases seen over a 15-year of period. All children had a small dimple or a pinhole on the skin of the occipital region. On admission they had the signs of increased intracranial pressure, while 3 of them still suffered from signs of meningitis resulting from a bacterial infection through the dermal sinus. CT scan and MR images revealed both the route of the dermal sinus and intracranial lesions. Total resection was successfully achieved before various treatments in all patients without nervous sequelae. In conclusion, a posterior fossa dermoid cyst should be considered in all children with an occipital dermal sinus. Cerebellar abscesses will arise once bacterial infection has occurred through the associated dermal sinus. Radiological studies such as CT scans and MR images can help confirm the diagnosis and locate the lesions. Early neurosurgical interventions including external ventricular drainage, external abscess drainage and primary removal should be planned as soon as possible in accord with the children's condition.

Posterior Fossa Dermoid Cysts in Association with Klippel-Feil Syndrome: Report of Three Cases

Although the association of spinal lumbosacral dysraphism and congenital spinal dermoid tumors is well known, the association of craniocervical spinal anomalies and posterior fossa dermoids has only been recognized recently. Advances in imaging technology and awareness of the association likely contribute to an increase in recently reported cases.

Cerebellar abscesses secondary to occipital dermoid cyst with dermal sinus: Case report

BACKGROUND Hydrocephalus and cerebellar abscesses as the principal manifestations of posterior fossa dermoid cyst are rare. In addition, extradural dermoid cyst of the posterior fossa has been described in only 9 cases in the literature. We present an unusual case of obstructive hydrocephalus due to cerebellar abscesses induced by an adjacent extradural dermoid cyst with complete occipital dermal sinus. CASE DESCRIPTION A 14-month-old child presented with acute raised intracranially pressure, seizures, and meningitis. Neuroradiological studies revealed cerebellar cysts with ring enhancement associated with a contiguous occipital cyst, with compression of the adjacent cisterns and the fourth ventricle causing hydrocephalus. The diagnosis of cerebellar abscesses with congenital occipital defect was briefly entertained. The patient was treated by radical excision of the occipital cyst with hair contents, the dermal sinus, and the abscesses through a suboccipital approach, followed by systemic antibiotic therapy with a good outcome. Pathologic examination revealed a dermoid cyst. CONCLUSION Posterior fossa dermoid cyst should be considered in all children with occipital skin lesions, especially dermal sinus. CT scan and MRI are the methods of choice for further investigation of suspect congenital dermal lesions. Neurosurgical treatment of these malformations should be planned early to prevent the high incidence of infections such as bacterial meningitis and cerebellar abscess. Clinical presentation, diagnostic evaluation, and treatment of these rare lesions are reviewed.

Klippel–Feil syndrome associated with posterior fossa dermoid cyst. Case report

A patient with association of Klippel-Feil syndrome and posterior fossa dermoid cyst is presented. The patient, a 36-year-old man, presented with an acute obstructive hydrocephalus due to the cyst and exhibited the typical triad of the Klippel-Feil abnormality with short neck, low hairline implantation and limited neck motion along with a complex cervical vertebrae fusion. The anatomical and clinical features as well as the pathophysiology of this rare association are discussed after a review of the literature. [Neurol Res 2002; 24: 501-504]